Scribes for physician burnout: How scribes help reconnect doctors with their patients


Recently, I had an opportunity to drop in on two of the foremost researchers in physician burnout, Sara Poplau and Mark Linzer of Hennepin County Medical Center in Minneapolis. We chatted about various aspects of the current burnout crisis and exciting new initiatives on the horizon. Then we spent some time contemplating a frustrating truth: leaders in health care often fail to acknowledge a reality that leaders in other industries have long embraced: treat your employees well, prioritize their well-being and safety, and you will reap benefits in your most important performance goals. It’s a proven strategy for success.

But try to convince board members and the C-suite of a hospital, health system, or large physician practice to free up the resources to prevent burnout, and you may find yourself out of breath and red in the face. Despite the fact that burnout costs so much — more medical errors, worse patient satisfaction, less engagement in improvement initiatives the direct costs of recruiting and replacing physicians and nurses who have left — few leaders are ready to invest in prevention. We shook our heads in collective dismay.

Linzer walked to his desk and held up a framed watercolor. Painted by Linzer’s brother, Daryl Wofford, “The Scribe,” depicts three individuals in an exam room: on the right side, a physician and a patient in conversation, and on the left, a young man typing on a laptop.

“This is our goal. This is what we want.” Linzer said. “A physician, freed from typing by the scribe, who is connecting with her patient — and a patient, who is happy because she is getting what she came for — a healing connection with her care provider. Relationships drive satisfaction. And that’s true for patients and care providers.”

I asked about the scribe program at Hennepin County.

The department of medicine began offering scribes several months ago, paying for 50 percent of the costs while the medical center covers the other half. After two months, Linzer asked every physician and nurse practitioner in the clinic that participated in the pilot program two questions: Would you be willing to see more patients with a scribe? Would you be willing to take a pay cut to offset the cost of the scribe? Every single clinician said yes to both questions. “When we have the opportunity to get back to spending time with patients, we realize how much we’ve been missing. The documentation gets in the way. A scribe program is one option for helping clinicians get back to connecting with patients.”

Another aspect of burnout prevention that leaders would do well to consider: a healthy workplace and the opportunity to derive meaning from work (caring for patients instead of slogging through data entry) increase the likelihood that your organization will avoid the substantial costs of replacing a physician (estimated to be $500,000 apiece) and help build a cadre of physicians who are loyal to their organization and able to engage in improvement initiatives that will move the needle on the performance metrics that keep top leaders up at night.

I realize that the work of executive leaders requires juggling many priorities. But careful stewardship of an organization’s most precious resource — its people — and prioritizing the development of healthy, high-performing clinical teams seems like a no-brainer to me.

Diane W. Shannon is an internal medicine physician who blogs at Shannon Healthcare Communications.

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